|
HC IR INSERTION CATH TUNNELED INTRAPERI W FLUORO
|
Facility
|
IP
|
$4,845.89
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
36100219
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,149.83 |
| Max. Negotiated Rate |
$4,845.89 |
| Rate for Payer: Aetna Commercial |
$4,361.30
|
| Rate for Payer: ASR ASR |
$4,700.51
|
| Rate for Payer: ASR Commercial |
$4,700.51
|
| Rate for Payer: BCBS Trust/PPO |
$3,948.92
|
| Rate for Payer: BCN Commercial |
$3,757.02
|
| Rate for Payer: Cash Price |
$3,876.71
|
| Rate for Payer: Cofinity Commercial |
$4,555.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,876.71
|
| Rate for Payer: Healthscope Commercial |
$4,845.89
|
| Rate for Payer: Healthscope Whirlpool |
$4,700.51
|
| Rate for Payer: Mclaren Commercial |
$4,361.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,119.01
|
| Rate for Payer: Nomi Health Commercial |
$3,973.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,149.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,264.38
|
|
|
HC IR INSERTION CHEST PORT ABOVE 5 YRS AGE
|
Facility
|
IP
|
$4,860.88
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
36100125
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,159.57 |
| Max. Negotiated Rate |
$4,860.88 |
| Rate for Payer: Aetna Commercial |
$4,374.79
|
| Rate for Payer: ASR ASR |
$4,715.05
|
| Rate for Payer: ASR Commercial |
$4,715.05
|
| Rate for Payer: BCBS Trust/PPO |
$3,961.13
|
| Rate for Payer: BCN Commercial |
$3,768.64
|
| Rate for Payer: Cash Price |
$3,888.70
|
| Rate for Payer: Cofinity Commercial |
$4,569.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,888.70
|
| Rate for Payer: Healthscope Commercial |
$4,860.88
|
| Rate for Payer: Healthscope Whirlpool |
$4,715.05
|
| Rate for Payer: Mclaren Commercial |
$4,374.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,131.75
|
| Rate for Payer: Nomi Health Commercial |
$3,985.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,159.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,277.57
|
|
|
HC IR INSERTION CHEST PORT ABOVE 5 YRS AGE
|
Facility
|
OP
|
$4,860.88
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
36100125
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$4,860.88 |
| Rate for Payer: Aetna Commercial |
$4,374.79
|
| Rate for Payer: Aetna Medicare |
$3,069.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: ASR ASR |
$4,715.05
|
| Rate for Payer: ASR Commercial |
$4,715.05
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$3,980.57
|
| Rate for Payer: BCN Commercial |
$3,768.64
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$3,888.70
|
| Rate for Payer: Cash Price |
$3,888.70
|
| Rate for Payer: Cofinity Commercial |
$4,569.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,888.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$4,860.88
|
| Rate for Payer: Healthscope Whirlpool |
$4,715.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$4,374.79
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,131.75
|
| Rate for Payer: Nomi Health Commercial |
$3,985.92
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,376.66
|
| Rate for Payer: PHP Medicaid |
$1,645.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,159.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,259.10
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$3,407.48
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,277.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$4,758.02
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP DNSP |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC IR INSERTION CHEST PORT LESS THAN 5 YRS AGE
|
Facility
|
IP
|
$4,573.82
|
|
|
Service Code
|
CPT 36560
|
| Hospital Charge Code |
36100124
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,972.98 |
| Max. Negotiated Rate |
$4,573.82 |
| Rate for Payer: Aetna Commercial |
$4,116.44
|
| Rate for Payer: ASR ASR |
$4,436.61
|
| Rate for Payer: ASR Commercial |
$4,436.61
|
| Rate for Payer: BCBS Trust/PPO |
$3,727.21
|
| Rate for Payer: BCN Commercial |
$3,546.08
|
| Rate for Payer: Cash Price |
$3,659.06
|
| Rate for Payer: Cofinity Commercial |
$4,299.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,659.06
|
| Rate for Payer: Healthscope Commercial |
$4,573.82
|
| Rate for Payer: Healthscope Whirlpool |
$4,436.61
|
| Rate for Payer: Mclaren Commercial |
$4,116.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,887.75
|
| Rate for Payer: Nomi Health Commercial |
$3,750.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,972.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,024.96
|
|
|
HC IR INSERTION CHEST PORT LESS THAN 5 YRS AGE
|
Facility
|
OP
|
$4,573.82
|
|
|
Service Code
|
CPT 36560
|
| Hospital Charge Code |
36100124
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$4,758.02 |
| Rate for Payer: Aetna Commercial |
$4,116.44
|
| Rate for Payer: Aetna Medicare |
$3,069.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: ASR ASR |
$4,436.61
|
| Rate for Payer: ASR Commercial |
$4,436.61
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$3,745.50
|
| Rate for Payer: BCN Commercial |
$3,546.08
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$3,659.06
|
| Rate for Payer: Cash Price |
$3,659.06
|
| Rate for Payer: Cofinity Commercial |
$4,299.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,659.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$4,573.82
|
| Rate for Payer: Healthscope Whirlpool |
$4,436.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$4,116.44
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,887.75
|
| Rate for Payer: Nomi Health Commercial |
$3,750.53
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,376.66
|
| Rate for Payer: PHP Medicaid |
$1,645.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,972.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,007.58
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$3,206.25
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,024.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$4,758.02
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP DNSP |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC IR INSERT TUNNEL PERI CATH W PORT
|
Facility
|
OP
|
$4,865.92
|
|
|
Service Code
|
CPT 49419
|
| Hospital Charge Code |
36100366
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,825.83 |
| Max. Negotiated Rate |
$8,171.71 |
| Rate for Payer: Aetna Commercial |
$4,379.33
|
| Rate for Payer: Aetna Medicare |
$5,272.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,590.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,590.09
|
| Rate for Payer: ASR ASR |
$4,719.94
|
| Rate for Payer: ASR Commercial |
$4,719.94
|
| Rate for Payer: BCBS Complete |
$2,967.12
|
| Rate for Payer: BCBS MAPPO |
$5,272.07
|
| Rate for Payer: BCBS Trust/PPO |
$3,984.70
|
| Rate for Payer: BCN Commercial |
$3,772.55
|
| Rate for Payer: BCN Medicare Advantage |
$5,272.07
|
| Rate for Payer: Cash Price |
$3,892.74
|
| Rate for Payer: Cash Price |
$3,892.74
|
| Rate for Payer: Cofinity Commercial |
$4,573.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,892.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,272.07
|
| Rate for Payer: Healthscope Commercial |
$4,865.92
|
| Rate for Payer: Healthscope Whirlpool |
$4,719.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,272.07
|
| Rate for Payer: Mclaren Commercial |
$4,379.33
|
| Rate for Payer: Mclaren Medicaid |
$2,825.83
|
| Rate for Payer: Mclaren Medicare |
$5,272.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,535.67
|
| Rate for Payer: Meridian Medicaid |
$2,967.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,062.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,136.03
|
| Rate for Payer: Nomi Health Commercial |
$3,990.05
|
| Rate for Payer: PACE Medicare |
$5,008.47
|
| Rate for Payer: PACE SWMI |
$5,272.07
|
| Rate for Payer: PHP Commercial |
$5,799.28
|
| Rate for Payer: PHP Medicaid |
$2,825.83
|
| Rate for Payer: PHP Medicare Advantage |
$5,272.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,825.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,162.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,263.52
|
| Rate for Payer: Priority Health Medicare |
$5,272.07
|
| Rate for Payer: Priority Health Narrow Network |
$3,411.01
|
| Rate for Payer: Railroad Medicare Medicare |
$5,272.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,282.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,272.07
|
| Rate for Payer: UHC Exchange |
$8,171.71
|
| Rate for Payer: UHC Medicare Advantage |
$5,272.07
|
| Rate for Payer: UHCCP DNSP |
$5,272.07
|
| Rate for Payer: UHCCP Medicaid |
$2,825.83
|
| Rate for Payer: VA VA |
$5,272.07
|
|
|
HC IR INSERT TUNNEL PERI CATH W PORT
|
Facility
|
IP
|
$4,865.92
|
|
|
Service Code
|
CPT 49419
|
| Hospital Charge Code |
36100366
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,162.85 |
| Max. Negotiated Rate |
$4,865.92 |
| Rate for Payer: Aetna Commercial |
$4,379.33
|
| Rate for Payer: ASR ASR |
$4,719.94
|
| Rate for Payer: ASR Commercial |
$4,719.94
|
| Rate for Payer: BCBS Trust/PPO |
$3,965.24
|
| Rate for Payer: BCN Commercial |
$3,772.55
|
| Rate for Payer: Cash Price |
$3,892.74
|
| Rate for Payer: Cofinity Commercial |
$4,573.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,892.74
|
| Rate for Payer: Healthscope Commercial |
$4,865.92
|
| Rate for Payer: Healthscope Whirlpool |
$4,719.94
|
| Rate for Payer: Mclaren Commercial |
$4,379.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,136.03
|
| Rate for Payer: Nomi Health Commercial |
$3,990.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,162.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,282.01
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM
|
Facility
|
IP
|
$1,975.72
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000198
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,284.22 |
| Max. Negotiated Rate |
$1,975.72 |
| Rate for Payer: Aetna Commercial |
$1,778.15
|
| Rate for Payer: ASR ASR |
$1,916.45
|
| Rate for Payer: ASR Commercial |
$1,916.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,610.01
|
| Rate for Payer: BCN Commercial |
$1,531.78
|
| Rate for Payer: Cash Price |
$1,580.58
|
| Rate for Payer: Cofinity Commercial |
$1,857.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,580.58
|
| Rate for Payer: Healthscope Commercial |
$1,975.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,916.45
|
| Rate for Payer: Mclaren Commercial |
$1,778.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,679.36
|
| Rate for Payer: Nomi Health Commercial |
$1,620.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,284.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,738.63
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM
|
Facility
|
OP
|
$1,975.72
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000198
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,284.22 |
| Max. Negotiated Rate |
$4,758.02 |
| Rate for Payer: Aetna Commercial |
$1,778.15
|
| Rate for Payer: Aetna Medicare |
$3,069.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: ASR ASR |
$1,916.45
|
| Rate for Payer: ASR Commercial |
$1,916.45
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,617.92
|
| Rate for Payer: BCN Commercial |
$1,531.78
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$1,580.58
|
| Rate for Payer: Cash Price |
$1,580.58
|
| Rate for Payer: Cofinity Commercial |
$1,857.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,580.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$1,975.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,916.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$1,778.15
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,679.36
|
| Rate for Payer: Nomi Health Commercial |
$1,620.09
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,376.66
|
| Rate for Payer: PHP Medicaid |
$1,645.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,284.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,731.13
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,384.98
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,738.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$4,758.02
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP DNSP |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM BILAT
|
Facility
|
OP
|
$2,587.41
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000199
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$4,758.02 |
| Rate for Payer: Aetna Commercial |
$2,328.67
|
| Rate for Payer: Aetna Medicare |
$3,069.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: ASR ASR |
$2,509.79
|
| Rate for Payer: ASR Commercial |
$2,509.79
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,118.83
|
| Rate for Payer: BCN Commercial |
$2,006.02
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$2,069.93
|
| Rate for Payer: Cash Price |
$2,069.93
|
| Rate for Payer: Cofinity Commercial |
$2,432.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,069.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$2,587.41
|
| Rate for Payer: Healthscope Whirlpool |
$2,509.79
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$2,328.67
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,199.30
|
| Rate for Payer: Nomi Health Commercial |
$2,121.68
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,376.66
|
| Rate for Payer: PHP Medicaid |
$1,645.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,681.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,267.09
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,813.77
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,276.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$4,758.02
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP DNSP |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM BILAT
|
Facility
|
IP
|
$2,587.41
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000199
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,681.82 |
| Max. Negotiated Rate |
$2,587.41 |
| Rate for Payer: Aetna Commercial |
$2,328.67
|
| Rate for Payer: ASR ASR |
$2,509.79
|
| Rate for Payer: ASR Commercial |
$2,509.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,108.48
|
| Rate for Payer: BCN Commercial |
$2,006.02
|
| Rate for Payer: Cash Price |
$2,069.93
|
| Rate for Payer: Cofinity Commercial |
$2,432.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,069.93
|
| Rate for Payer: Healthscope Commercial |
$2,587.41
|
| Rate for Payer: Healthscope Whirlpool |
$2,509.79
|
| Rate for Payer: Mclaren Commercial |
$2,328.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,199.30
|
| Rate for Payer: Nomi Health Commercial |
$2,121.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,681.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,276.92
|
|
|
HC IR LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$1,392.83
|
|
|
Service Code
|
CPT 62328
|
| Hospital Charge Code |
36100578
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$905.34 |
| Max. Negotiated Rate |
$1,392.83 |
| Rate for Payer: Aetna Commercial |
$1,253.55
|
| Rate for Payer: ASR ASR |
$1,351.05
|
| Rate for Payer: ASR Commercial |
$1,351.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,135.02
|
| Rate for Payer: BCN Commercial |
$1,079.86
|
| Rate for Payer: Cash Price |
$1,114.26
|
| Rate for Payer: Cofinity Commercial |
$1,309.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,114.26
|
| Rate for Payer: Healthscope Commercial |
$1,392.83
|
| Rate for Payer: Healthscope Whirlpool |
$1,351.05
|
| Rate for Payer: Mclaren Commercial |
$1,253.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,183.91
|
| Rate for Payer: Nomi Health Commercial |
$1,142.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$905.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,225.69
|
|
|
HC IR LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$1,392.83
|
|
|
Service Code
|
CPT 62328
|
| Hospital Charge Code |
36100578
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$362.01 |
| Max. Negotiated Rate |
$1,392.83 |
| Rate for Payer: Aetna Commercial |
$1,253.55
|
| Rate for Payer: Aetna Medicare |
$675.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$844.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$844.25
|
| Rate for Payer: ASR ASR |
$1,351.05
|
| Rate for Payer: ASR Commercial |
$1,351.05
|
| Rate for Payer: BCBS Complete |
$380.12
|
| Rate for Payer: BCBS MAPPO |
$675.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,140.59
|
| Rate for Payer: BCN Commercial |
$1,079.86
|
| Rate for Payer: BCN Medicare Advantage |
$675.40
|
| Rate for Payer: Cash Price |
$1,114.26
|
| Rate for Payer: Cash Price |
$1,114.26
|
| Rate for Payer: Cofinity Commercial |
$1,309.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,114.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.40
|
| Rate for Payer: Healthscope Commercial |
$1,392.83
|
| Rate for Payer: Healthscope Whirlpool |
$1,351.05
|
| Rate for Payer: Humana Choice PPO Medicare |
$675.40
|
| Rate for Payer: Mclaren Commercial |
$1,253.55
|
| Rate for Payer: Mclaren Medicaid |
$362.01
|
| Rate for Payer: Mclaren Medicare |
$675.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$709.17
|
| Rate for Payer: Meridian Medicaid |
$380.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$776.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,183.91
|
| Rate for Payer: Nomi Health Commercial |
$1,142.12
|
| Rate for Payer: PACE Medicare |
$641.63
|
| Rate for Payer: PACE SWMI |
$675.40
|
| Rate for Payer: PHP Commercial |
$742.94
|
| Rate for Payer: PHP Medicaid |
$362.01
|
| Rate for Payer: PHP Medicare Advantage |
$675.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$905.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,220.40
|
| Rate for Payer: Priority Health Medicare |
$675.40
|
| Rate for Payer: Priority Health Narrow Network |
$976.37
|
| Rate for Payer: Railroad Medicare Medicare |
$675.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,225.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$675.40
|
| Rate for Payer: UHC Exchange |
$1,046.87
|
| Rate for Payer: UHC Medicare Advantage |
$675.40
|
| Rate for Payer: UHCCP DNSP |
$675.40
|
| Rate for Payer: UHCCP Medicaid |
$362.01
|
| Rate for Payer: VA VA |
$675.40
|
|
|
HC IR LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
IP
|
$1,062.63
|
|
|
Service Code
|
CPT 62329
|
| Hospital Charge Code |
36100579
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$690.71 |
| Max. Negotiated Rate |
$1,062.63 |
| Rate for Payer: Aetna Commercial |
$956.37
|
| Rate for Payer: ASR ASR |
$1,030.75
|
| Rate for Payer: ASR Commercial |
$1,030.75
|
| Rate for Payer: BCBS Trust/PPO |
$865.94
|
| Rate for Payer: BCN Commercial |
$823.86
|
| Rate for Payer: Cash Price |
$850.10
|
| Rate for Payer: Cofinity Commercial |
$998.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$850.10
|
| Rate for Payer: Healthscope Commercial |
$1,062.63
|
| Rate for Payer: Healthscope Whirlpool |
$1,030.75
|
| Rate for Payer: Mclaren Commercial |
$956.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$903.24
|
| Rate for Payer: Nomi Health Commercial |
$871.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$690.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$935.11
|
|
|
HC IR LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
OP
|
$1,062.63
|
|
|
Service Code
|
CPT 62329
|
| Hospital Charge Code |
36100579
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$362.01 |
| Max. Negotiated Rate |
$1,062.63 |
| Rate for Payer: Aetna Commercial |
$956.37
|
| Rate for Payer: Aetna Medicare |
$675.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$844.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$844.25
|
| Rate for Payer: ASR ASR |
$1,030.75
|
| Rate for Payer: ASR Commercial |
$1,030.75
|
| Rate for Payer: BCBS Complete |
$380.12
|
| Rate for Payer: BCBS MAPPO |
$675.40
|
| Rate for Payer: BCBS Trust/PPO |
$870.19
|
| Rate for Payer: BCN Commercial |
$823.86
|
| Rate for Payer: BCN Medicare Advantage |
$675.40
|
| Rate for Payer: Cash Price |
$850.10
|
| Rate for Payer: Cash Price |
$850.10
|
| Rate for Payer: Cofinity Commercial |
$998.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$850.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.40
|
| Rate for Payer: Healthscope Commercial |
$1,062.63
|
| Rate for Payer: Healthscope Whirlpool |
$1,030.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$675.40
|
| Rate for Payer: Mclaren Commercial |
$956.37
|
| Rate for Payer: Mclaren Medicaid |
$362.01
|
| Rate for Payer: Mclaren Medicare |
$675.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$709.17
|
| Rate for Payer: Meridian Medicaid |
$380.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$776.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$903.24
|
| Rate for Payer: Nomi Health Commercial |
$871.36
|
| Rate for Payer: PACE Medicare |
$641.63
|
| Rate for Payer: PACE SWMI |
$675.40
|
| Rate for Payer: PHP Commercial |
$742.94
|
| Rate for Payer: PHP Medicaid |
$362.01
|
| Rate for Payer: PHP Medicare Advantage |
$675.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$690.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$931.08
|
| Rate for Payer: Priority Health Medicare |
$675.40
|
| Rate for Payer: Priority Health Narrow Network |
$744.90
|
| Rate for Payer: Railroad Medicare Medicare |
$675.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$935.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$675.40
|
| Rate for Payer: UHC Exchange |
$1,046.87
|
| Rate for Payer: UHC Medicare Advantage |
$675.40
|
| Rate for Payer: UHCCP DNSP |
$675.40
|
| Rate for Payer: UHCCP Medicaid |
$362.01
|
| Rate for Payer: VA VA |
$675.40
|
|
|
HC IR LYMPHANGIOGRAM BILATERAL
|
Facility
|
OP
|
$3,028.19
|
|
|
Service Code
|
CPT 75807
|
| Hospital Charge Code |
32000201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$4,758.02 |
| Rate for Payer: Aetna Commercial |
$2,725.37
|
| Rate for Payer: Aetna Medicare |
$3,069.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: ASR ASR |
$2,937.34
|
| Rate for Payer: ASR Commercial |
$2,937.34
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,479.78
|
| Rate for Payer: BCN Commercial |
$2,347.76
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$2,422.55
|
| Rate for Payer: Cash Price |
$2,422.55
|
| Rate for Payer: Cofinity Commercial |
$2,846.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,422.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$3,028.19
|
| Rate for Payer: Healthscope Whirlpool |
$2,937.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$2,725.37
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,573.96
|
| Rate for Payer: Nomi Health Commercial |
$2,483.12
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,376.66
|
| Rate for Payer: PHP Medicaid |
$1,645.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,968.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,653.30
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,122.76
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,664.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$4,758.02
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP DNSP |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC IR LYMPHANGIOGRAM BILATERAL
|
Facility
|
IP
|
$3,028.19
|
|
|
Service Code
|
CPT 75807
|
| Hospital Charge Code |
32000201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,968.32 |
| Max. Negotiated Rate |
$3,028.19 |
| Rate for Payer: Aetna Commercial |
$2,725.37
|
| Rate for Payer: ASR ASR |
$2,937.34
|
| Rate for Payer: ASR Commercial |
$2,937.34
|
| Rate for Payer: BCBS Trust/PPO |
$2,467.67
|
| Rate for Payer: BCN Commercial |
$2,347.76
|
| Rate for Payer: Cash Price |
$2,422.55
|
| Rate for Payer: Cofinity Commercial |
$2,846.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,422.55
|
| Rate for Payer: Healthscope Commercial |
$3,028.19
|
| Rate for Payer: Healthscope Whirlpool |
$2,937.34
|
| Rate for Payer: Mclaren Commercial |
$2,725.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,573.96
|
| Rate for Payer: Nomi Health Commercial |
$2,483.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,968.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,664.81
|
|
|
HC IR LYMPHANGIOGRAM UNILATERAL
|
Facility
|
OP
|
$1,299.60
|
|
|
Service Code
|
CPT 75805
|
| Hospital Charge Code |
32000324
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$844.74 |
| Max. Negotiated Rate |
$4,758.02 |
| Rate for Payer: Aetna Commercial |
$1,169.64
|
| Rate for Payer: Aetna Medicare |
$3,069.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: ASR ASR |
$1,260.61
|
| Rate for Payer: ASR Commercial |
$1,260.61
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,064.24
|
| Rate for Payer: BCN Commercial |
$1,007.58
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$1,039.68
|
| Rate for Payer: Cash Price |
$1,039.68
|
| Rate for Payer: Cofinity Commercial |
$1,221.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,039.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$1,299.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,260.61
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$1,169.64
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,104.66
|
| Rate for Payer: Nomi Health Commercial |
$1,065.67
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,376.66
|
| Rate for Payer: PHP Medicaid |
$1,645.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$844.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,138.71
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$911.02
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,143.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$4,758.02
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP DNSP |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC IR LYMPHANGIOGRAM UNILATERAL
|
Facility
|
IP
|
$1,299.60
|
|
|
Service Code
|
CPT 75805
|
| Hospital Charge Code |
32000324
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$844.74 |
| Max. Negotiated Rate |
$1,299.60 |
| Rate for Payer: Aetna Commercial |
$1,169.64
|
| Rate for Payer: ASR ASR |
$1,260.61
|
| Rate for Payer: ASR Commercial |
$1,260.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,059.04
|
| Rate for Payer: BCN Commercial |
$1,007.58
|
| Rate for Payer: Cash Price |
$1,039.68
|
| Rate for Payer: Cofinity Commercial |
$1,221.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,039.68
|
| Rate for Payer: Healthscope Commercial |
$1,299.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,260.61
|
| Rate for Payer: Mclaren Commercial |
$1,169.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,104.66
|
| Rate for Payer: Nomi Health Commercial |
$1,065.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$844.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,143.65
|
|
|
HC IR LYMPHATIC SYSTEM UNLISTED P
|
Facility
|
IP
|
$583.28
|
|
|
Service Code
|
CPT 38999
|
| Hospital Charge Code |
36100188
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$379.13 |
| Max. Negotiated Rate |
$583.28 |
| Rate for Payer: Aetna Commercial |
$524.95
|
| Rate for Payer: ASR ASR |
$565.78
|
| Rate for Payer: ASR Commercial |
$565.78
|
| Rate for Payer: BCBS Trust/PPO |
$475.31
|
| Rate for Payer: BCN Commercial |
$452.22
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$548.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Healthscope Commercial |
$583.28
|
| Rate for Payer: Healthscope Whirlpool |
$565.78
|
| Rate for Payer: Mclaren Commercial |
$524.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: Nomi Health Commercial |
$478.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$513.29
|
|
|
HC IR LYMPHATIC SYSTEM UNLISTED P
|
Facility
|
OP
|
$583.28
|
|
|
Service Code
|
CPT 38999
|
| Hospital Charge Code |
36100188
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$228.53 |
| Max. Negotiated Rate |
$660.87 |
| Rate for Payer: Aetna Commercial |
$524.95
|
| Rate for Payer: Aetna Medicare |
$426.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$532.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$532.96
|
| Rate for Payer: ASR ASR |
$565.78
|
| Rate for Payer: ASR Commercial |
$565.78
|
| Rate for Payer: BCBS Complete |
$239.96
|
| Rate for Payer: BCBS MAPPO |
$426.37
|
| Rate for Payer: BCBS Trust/PPO |
$477.65
|
| Rate for Payer: BCN Commercial |
$452.22
|
| Rate for Payer: BCN Medicare Advantage |
$426.37
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$548.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$426.37
|
| Rate for Payer: Healthscope Commercial |
$583.28
|
| Rate for Payer: Healthscope Whirlpool |
$565.78
|
| Rate for Payer: Humana Choice PPO Medicare |
$426.37
|
| Rate for Payer: Mclaren Commercial |
$524.95
|
| Rate for Payer: Mclaren Medicaid |
$228.53
|
| Rate for Payer: Mclaren Medicare |
$426.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$447.69
|
| Rate for Payer: Meridian Medicaid |
$239.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$490.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: Nomi Health Commercial |
$478.29
|
| Rate for Payer: PACE Medicare |
$405.05
|
| Rate for Payer: PACE SWMI |
$426.37
|
| Rate for Payer: PHP Commercial |
$469.01
|
| Rate for Payer: PHP Medicaid |
$228.53
|
| Rate for Payer: PHP Medicare Advantage |
$426.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$511.07
|
| Rate for Payer: Priority Health Medicare |
$426.37
|
| Rate for Payer: Priority Health Narrow Network |
$408.88
|
| Rate for Payer: Railroad Medicare Medicare |
$426.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$513.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$426.37
|
| Rate for Payer: UHC Exchange |
$660.87
|
| Rate for Payer: UHC Medicare Advantage |
$426.37
|
| Rate for Payer: UHCCP DNSP |
$426.37
|
| Rate for Payer: UHCCP Medicaid |
$228.53
|
| Rate for Payer: VA VA |
$426.37
|
|
|
HC IR MESENTERIC VISCERAL ANGIOGR
|
Facility
|
OP
|
$3,674.46
|
|
|
Service Code
|
CPT 75726
|
| Hospital Charge Code |
32000193
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,388.40 |
| Max. Negotiated Rate |
$8,171.71 |
| Rate for Payer: Aetna Commercial |
$3,307.01
|
| Rate for Payer: Aetna Medicare |
$5,272.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,590.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,590.09
|
| Rate for Payer: ASR ASR |
$3,564.23
|
| Rate for Payer: ASR Commercial |
$3,564.23
|
| Rate for Payer: BCBS Complete |
$2,967.12
|
| Rate for Payer: BCBS MAPPO |
$5,272.07
|
| Rate for Payer: BCBS Trust/PPO |
$3,009.02
|
| Rate for Payer: BCN Commercial |
$2,848.81
|
| Rate for Payer: BCN Medicare Advantage |
$5,272.07
|
| Rate for Payer: Cash Price |
$2,939.57
|
| Rate for Payer: Cash Price |
$2,939.57
|
| Rate for Payer: Cofinity Commercial |
$3,453.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,939.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,272.07
|
| Rate for Payer: Healthscope Commercial |
$3,674.46
|
| Rate for Payer: Healthscope Whirlpool |
$3,564.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$5,272.07
|
| Rate for Payer: Mclaren Commercial |
$3,307.01
|
| Rate for Payer: Mclaren Medicaid |
$2,825.83
|
| Rate for Payer: Mclaren Medicare |
$5,272.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,535.67
|
| Rate for Payer: Meridian Medicaid |
$2,967.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,062.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,123.29
|
| Rate for Payer: Nomi Health Commercial |
$3,013.06
|
| Rate for Payer: PACE Medicare |
$5,008.47
|
| Rate for Payer: PACE SWMI |
$5,272.07
|
| Rate for Payer: PHP Commercial |
$5,799.28
|
| Rate for Payer: PHP Medicaid |
$2,825.83
|
| Rate for Payer: PHP Medicare Advantage |
$5,272.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,825.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,388.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,219.56
|
| Rate for Payer: Priority Health Medicare |
$5,272.07
|
| Rate for Payer: Priority Health Narrow Network |
$2,575.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5,272.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,233.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,272.07
|
| Rate for Payer: UHC Exchange |
$8,171.71
|
| Rate for Payer: UHC Medicare Advantage |
$5,272.07
|
| Rate for Payer: UHCCP DNSP |
$5,272.07
|
| Rate for Payer: UHCCP Medicaid |
$2,825.83
|
| Rate for Payer: VA VA |
$5,272.07
|
|
|
HC IR MESENTERIC VISCERAL ANGIOGR
|
Facility
|
IP
|
$3,674.46
|
|
|
Service Code
|
CPT 75726
|
| Hospital Charge Code |
32000193
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,388.40 |
| Max. Negotiated Rate |
$3,674.46 |
| Rate for Payer: Aetna Commercial |
$3,307.01
|
| Rate for Payer: ASR ASR |
$3,564.23
|
| Rate for Payer: ASR Commercial |
$3,564.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,994.32
|
| Rate for Payer: BCN Commercial |
$2,848.81
|
| Rate for Payer: Cash Price |
$2,939.57
|
| Rate for Payer: Cofinity Commercial |
$3,453.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,939.57
|
| Rate for Payer: Healthscope Commercial |
$3,674.46
|
| Rate for Payer: Healthscope Whirlpool |
$3,564.23
|
| Rate for Payer: Mclaren Commercial |
$3,307.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,123.29
|
| Rate for Payer: Nomi Health Commercial |
$3,013.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,388.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,233.52
|
|
|
HC IR MYELOGRAM LUMBAR
|
Facility
|
IP
|
$918.71
|
|
|
Service Code
|
CPT 72265
|
| Hospital Charge Code |
32000055
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$597.16 |
| Max. Negotiated Rate |
$918.71 |
| Rate for Payer: Aetna Commercial |
$826.84
|
| Rate for Payer: ASR ASR |
$891.15
|
| Rate for Payer: ASR Commercial |
$891.15
|
| Rate for Payer: BCBS Trust/PPO |
$748.66
|
| Rate for Payer: BCN Commercial |
$712.28
|
| Rate for Payer: Cash Price |
$734.97
|
| Rate for Payer: Cofinity Commercial |
$863.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.97
|
| Rate for Payer: Healthscope Commercial |
$918.71
|
| Rate for Payer: Healthscope Whirlpool |
$891.15
|
| Rate for Payer: Mclaren Commercial |
$826.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$780.90
|
| Rate for Payer: Nomi Health Commercial |
$753.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$808.46
|
|
|
HC IR MYELOGRAM LUMBAR
|
Facility
|
OP
|
$918.71
|
|
|
Service Code
|
CPT 72265
|
| Hospital Charge Code |
32000055
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$413.00 |
| Max. Negotiated Rate |
$1,194.32 |
| Rate for Payer: Aetna Commercial |
$826.84
|
| Rate for Payer: Aetna Medicare |
$770.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$963.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$963.16
|
| Rate for Payer: ASR ASR |
$891.15
|
| Rate for Payer: ASR Commercial |
$891.15
|
| Rate for Payer: BCBS Complete |
$433.65
|
| Rate for Payer: BCBS MAPPO |
$770.53
|
| Rate for Payer: BCBS Trust/PPO |
$752.33
|
| Rate for Payer: BCN Commercial |
$712.28
|
| Rate for Payer: BCN Medicare Advantage |
$770.53
|
| Rate for Payer: Cash Price |
$734.97
|
| Rate for Payer: Cash Price |
$734.97
|
| Rate for Payer: Cofinity Commercial |
$863.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$770.53
|
| Rate for Payer: Healthscope Commercial |
$918.71
|
| Rate for Payer: Healthscope Whirlpool |
$891.15
|
| Rate for Payer: Humana Choice PPO Medicare |
$770.53
|
| Rate for Payer: Mclaren Commercial |
$826.84
|
| Rate for Payer: Mclaren Medicaid |
$413.00
|
| Rate for Payer: Mclaren Medicare |
$770.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$809.06
|
| Rate for Payer: Meridian Medicaid |
$433.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$886.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$780.90
|
| Rate for Payer: Nomi Health Commercial |
$753.34
|
| Rate for Payer: PACE Medicare |
$732.00
|
| Rate for Payer: PACE SWMI |
$770.53
|
| Rate for Payer: PHP Commercial |
$847.58
|
| Rate for Payer: PHP Medicaid |
$413.00
|
| Rate for Payer: PHP Medicare Advantage |
$770.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$804.97
|
| Rate for Payer: Priority Health Medicare |
$770.53
|
| Rate for Payer: Priority Health Narrow Network |
$644.02
|
| Rate for Payer: Railroad Medicare Medicare |
$770.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$808.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$770.53
|
| Rate for Payer: UHC Exchange |
$1,194.32
|
| Rate for Payer: UHC Medicare Advantage |
$770.53
|
| Rate for Payer: UHCCP DNSP |
$770.53
|
| Rate for Payer: UHCCP Medicaid |
$413.00
|
| Rate for Payer: VA VA |
$770.53
|
|
